Individual
SALLY PECHSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.N.
Contact information
Practice address
295 NOBLE LN, CORRALES, NM 87048-7703
(808) 866-8142
Mailing address
PO BOX 2980, CORRALES, NM 87048-2980
(808) 866-8142
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT89872
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0172935
L&I PIN
WA
05
—
8330169
—
WA
01
—
9723PE
REGENCE BLUE SHIELD
WA
Enumeration date
05/02/2006
Last updated
04/01/2024
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